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Abstract

Patient mobility gives rise to some fundamental information requirements, such as the nature of the basket of services offered in the different Member States, how these are defined, how often they are used for particular patients, what their costs are, what prices are paid for them, the quality with which they are delivered, and their cost-effectiveness. This knowledge will enable both Member States and the European Commission to formulate coherent policies on patient mobility in a way that will preserve both the financial viability of existing health systems and the treasured principles of universality, equity and accessibility. Further, if patients are to benefit from the opportunity offered by the European Union’s emerging healthcare market, they too will need to know the nature, quality and costs of services available elsewhere. Finally, international comparison based on good quality data is an important tool for learning from best practice within and between countries.

However, international comparisons of service, cost and quality data are currently not routinely available for individual treatments. Up to now, healthcare cost comparisons have been usually made at an aggregate level and variations have been identified at the macro-level, e.g. in purchasing power parities (PPPs) per capita, as a percentage of GDP, distribution of expenditure per sector. Most fundamentally, analysis of international variation in the costs of individual services at the micro-level is difficult because of manifest limitations in the comparability of data. As a result, where cost data for individual treatments have become available, it has usually been unclear whether differences are due to (1) differences in the actual type of service delivered, e.g. in the technologies chosen or the human resources skills mix employed, (2) the intensity with which technologies or personnel are used per treatment episode (e.g. treatment time and length of stay), and (3) differences in input costs (e.g. costs of implant and hourly costs of personnel)....